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Flashcards in MSK Microbiology Deck (38)
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1
Q

what drug is used to treat staph aureus?

A

Flucloxacillin

2
Q

what is the side effect in the use of clindamycin?

A

C. diff

3
Q

where is adult osteomyelitis likely to occur?

A

long bone medullary cavity

4
Q

how do you class osteomyelitis?

A

by time

acute vs. chronic

5
Q

name the treatment approach to infection

A

debridement

antimicrobials

6
Q

if you can see bone, see tendon and infection, what is the diagnosis?

A

osteomyelitis

7
Q

osteomyelitis is a medical emergency.

true or false?

A

false

only if sepsis too

8
Q

you must start empiric antibiotics immediately in chronic osteomyelitis.

true or false?

A

false*

you can afford to wait a few days

9
Q

how long does debrided tissue take to be covered by soft tissue?

A

6 weeks

10
Q

how long is the treatment in osteomyelitis?

A

6 weeks

11
Q

coagulase negative staph only really cause problems in those with prosthetics

true or false?

A

true

coagulase negative staph only virulent in presence of plastic and metal

12
Q

name examples of osteomyelitis

A
open fractures
diabetes/vascular insufficiency
haematogeneous osteomyelitis
vertebral osteomyelitis
***
13
Q

describe staph aureus

A
common
coagulase positive
gram positive
clusters
produce enzymes
***
14
Q

what is the clue in open fracture infection?

A

poor wound healing

15
Q

in diabetes/venous insufficiency, what is the common pathogen?

A

often polymicrobial but staph aureus is most common

16
Q

in diabetes/venous insufficiency, what is the treatment?

A

debridement and antimicrobials

17
Q

what is the way to tell you what the infection is? best test?

A

bone biopsy

18
Q

what drugs do you use for gram negatives?

A

gentamycin*

19
Q

what is the alternative to flucloxacillin for people with a penicillin allergy?

A

vancomycin

20
Q

name the duration of treatment in diabetic foot infection.

A

mild - 7days*
moderate - 7days*
severe - 7days*
osteomyelitis - 6 weeks*

21
Q

what drugs do you use for anaerobes?

A

metronidazole*

22
Q

name the drug and allergy alternative and oral switch for gram positive cover.

A

Flucloxacillin IV
vancomycin if allergic
oral switch - doxycycline

23
Q

what drug is no use systemically?

A

vancomycin

topical treatment for bowel i.e. gastroenteritis

24
Q

who are the likely people to have haematogenous osteomyelitis?

A

prepubertal children
PWID
elderly

25
Q

what bone is most commonly affected in haematogenous osteomyelitis?

A

femur

26
Q

most common pathogen in endocarditis in PWID?

A

strep. viridians

27
Q

in vertebral osteomyelitis, what percentage have fever and what percentage have insidious pain?

A

50% - fever

90% - insidious pain

28
Q

what should you avoid in vertebral osteomyelitis initially?

A

empiric antibiotics

29
Q

how long should you be on antimicrobials for?

A

6 weeks minimum

30
Q

do you need to have pulmonary TB to have vertebral TB?

A

no - approx 50% do not

31
Q

what are the risk factors in prosthetic joint infection?

A

rheumatoidarthritis
diabetes
malnutrition
obesity

32
Q

what is time scale for early prosthetic infection?

A

less than a month

later is more than a month

33
Q

what is a biofilm?

A

extracellular matrix making a strong barrier to pathogen making it difficult for antimicrobials to work

34
Q

when is there re-implantation of the joint after infection?

A

after aggressive antibiotic therapy

35
Q

what is the classic tetanus - toxin mediated illness?

A

clostridium tetani

36
Q

describe clostridium tetani

A

Gm +ve

37
Q

what does tetanus cause?

A

spastic paralysis due to neurotoxin

38
Q

are survivors immune to tetanus?

A

NO